Bassotti G, Chiarioni G, Germani U, Battaglia E, Vantini I, Morelli A
Laboratorio di Motilità Intestinale, Sezione di Gastroenterologia ed Endoscopia Digestiva, Dipartimento di Medicina, Clinica, Patologia e Farmacologia, Università di Perugia, Italia.
Digestion. 1999 Jan-Feb;60(1):69-73. doi: 10.1159/000007591.
Chronic constipation is a frequent symptom among the general population, and a minority of cases do not respond to any therapeutic measures, except surgery. The purpose of this study was to test the residual colonic motor propulsive activity with a pharmacologic stimulus in a series of patients referred for severe constipation.
Twenty-five chronically constipated patients, slow transit type, age range 16-71 years, unresponsive to conventional medical treatment and referred for functional evaluation, entered the study.
Colonic manometry by means of an endoscopically positioned probe was carried out in all patients. Following a basal recording period, a placebo solution followed by 10 mg bisacodyl solution was infused into the colon through the more proximal recording port.
After bisacodyl infusion, about 90% of patients showed a motor response characterized by the appearance (within on average 13 +/- 3 min) of one or more high-amplitude propagated contractions, the manometric equivalent of mass movements, and about 75% of these were followed (mean 18.5 +/- 4 min) by defecation.
Physiological and pharmacological testing of colonic motor activity may be important in severely constipated patients, especially in those labeled as 'intractable', in whom more in depth investigation planning may encourage further therapeutic efforts.
慢性便秘是普通人群中的常见症状，除手术外，少数病例对任何治疗措施均无反应。本研究的目的是在一系列因严重便秘前来就诊的患者中，通过药物刺激来测试结肠残余的运动推进活性。
25例慢性便秘患者，为慢传输型，年龄范围16 - 71岁，对传统药物治疗无反应且前来进行功能评估，进入本研究。
所有患者均通过内镜放置探头进行结肠测压。在基础记录期后，通过近端记录端口向结肠内注入安慰剂溶液，随后注入10毫克比沙可啶溶液。
注入比沙可啶后，约90%的患者出现运动反应，其特征为（平均在13±3分钟内）出现一个或多个高振幅传播收缩，这是压力测定上相当于集团蠕动的表现，其中约75%的患者随后（平均18.5±4分钟）排便。
对严重便秘患者，尤其是那些被标记为“难治性”的患者，结肠运动活性的生理和药理测试可能很重要，在这些患者中，更深入的调查规划可能会促使进一步的治疗努力。
